TOBI 2016 (Total Occlusion and Bifurcation Interventions) was held on Thursday the 22nd and Friday the 23rd of September 2016, at the NH Laguna Palace Hotel in Mestre (Venice). It was dedicated to the care of patients with complex coronary lesions such as bifurcations and chronic occlusions. The event was organized to provide specific training to all professionals (doctors cardiologists, nurses, medical technicians) who work in cardiology laboratories and hemodynamics.

We interviewed Dr. Bernhard Reimers, Director of Clinical and Interventional Cardiology of Humanitas and Director of the courses at TOBI 2016, to find out more about the convention.


From left to right: Dr. Dennis Zavalloni, Dr. Patrizia Priest, Dr. Giulio Stefanini, Dr. Gabriel Gasparini, Dr. Bernhard Reimers, Dr. Paul Pagnotta.

What are the main diseases of the coronary arteries?

“First of all, it should be specified that the coronary arteries, from an anatomical point of view are present in different forms. They can be straight, winding, narrow, wide, closed or branched. The conference will address two very specific diseases: the bifurcations and occlusions of the coronary arteries. The split (bifurcation) consists of an artery dividing into two branches. As you can imagine, these are more complex to repair than a single coronary artery or a single tube. The total occlusions however, occur when a coronary artery is fully closed”.


What techniques are used to treat the two diseases?

“To treat the two conditions we can employ techniques that are partly consolidated and partly new. For the bifurcation we have numerous recent clinical studies that give us the chance to choose the best treatment for one type of split (forking) over another. Moreover, we can rely on new materials which should be compared though with the ones used so far and have given good results. In the case of an obstruction (occlusion) however, we are talking about CABG surgery (Coronary artery bypass graft surgery). This is a more invasive technique that gives good results. Our goal is to reach a coronary reopening success rate equal to that of surgery with bypass. In this field there are technological developments, new devices and innovative surgical techniques already, however, we are making progress year after year”.


occlusion and bifurcation interventions

Who are some of the greatest innovators in the treatment of occlusions?

“Our Japanese friends are universally recognized as masters in this type of intervention. Behind this there are also cultural reasons. Japanese patients often oppose bypass surgeries. This is because Japanese tradition indicates that while opening the chest the soul can escape from the body.

During the congress we were honored by the presence of two of the most famous Japanese leaders in the field. Both came to speak of their experience and show us live their operating abilities. The conference was the ideal setting to compare techniques and devices that are being developed in Europe, America East and West.”


How many people were expected for this event?

“We expected about two hundred people, including doctors, nurses and other professionals. The latter participated by presenting the latest devices in a close collaboration with the physicians present, and demonstrating how they will be improved in the future.”


What was the course about and how did it take place?

“It was a practical course, not a theoretical one, meaning that sessions were transmitted live from surgery via satellite. We had a busy program of interventions: a dozen from Humanitas but there were also connections with Moscow, Kuwait, and Oman which have strong growth centers. The public had the opportunity to watch the various procedures and interact with the presenters by asking questions and proposing alternative solutions.”


What can you tell us about the innovative techniques that were presented?

“The techniques were very particular and suitable for transmission via live video feed. In fact, the doctors themselves during these types of interventions have their sights set on a monitor and only intervene physically on the patient using wires and catheters.

We also presented a case of implantation of a device which controls narrowing of the coronary sinus. This is called a Reducer and has proven to be effective in reducing the symptoms of the patient with coronary non-releasable conditions. It is a relatively new technique but very promising.”


What was the main objective of the course?

“The goal of these courses is to ensure that the doctor comes home with a new know-how and increased chances of success during the most complex cases in his hospital.”